Christine Allison - Academia.edu (original) (raw)

Papers by Christine Allison

Ophthalmic and Physiological Optics, Jun 19, 2023

PurposeTo survey paediatric eye care providers to identify current patterns of prescribing for hy... more PurposeTo survey paediatric eye care providers to identify current patterns of prescribing for hyperopia.MethodsPaediatric eye care providers were invited, via email, to participate in a survey to evaluate current age‐based refractive error prescribing practices. Questions were designed to determine which factors may influence the survey participant's prescribing pattern (e.g., patient's age, magnitude of hyperopia, patient's symptoms, heterophoria and stereopsis) and if the providers were to prescribe, how much hyperopic correction would they prescribe (e.g., full or partial prescription). The response distributions by profession (optometry and ophthalmology) were compared using the Kolmogorov–Smirnov cumulative distribution function test.ResultsResponses were submitted by 738 participants regarding how they prescribe for their hyperopic patients. Most providers within each profession considered similar clinical factors when prescribing. The percentages of optometrists and ophthalmologists who reported considering the factor often differed significantly. Factors considered similarly by both optometrists and ophthalmologists were the presence of symptoms (98.0%, p = 0.14), presence of astigmatism and/or anisometropia (97.5%, p = 0.06) and the possibility of teasing (8.3%, p = 0.49). A wide range of prescribing was observed within each profession, with some providers reporting that they would prescribe for low levels of hyperopia while others reported that they would never prescribe. When prescribing for bilateral hyperopia in children with age‐normal visual acuity and no manifest deviation or symptoms, the threshold for prescribing decreased with age for both professions, with ophthalmologists typically prescribing 1.5–2 D less than optometrists. The threshold for prescribing also decreased for both optometrists and ophthalmologists when children had associated clinical factors (e.g., esophoria or reduced near visual function). Optometrists and ophthalmologists most commonly prescribed based on cycloplegic refraction, although optometrists most commonly prescribed based on both the manifest and cycloplegic refraction for children ≥7 years.ConclusionPrescribing patterns for paediatric hyperopia vary significantly among eye care providers.

Investigative Ophthalmology & Visual Science, Apr 28, 2009

Archives of Ophthalmology, May 1, 2012

To determine the efficacy of refractive correction alone and patching treatment with near activit... more To determine the efficacy of refractive correction alone and patching treatment with near activities on amblyopia associated with myopic anisometropia in children aged 4 to less than 14 years. The associations of visual acuity (VA) improvement with age, degree of anisometropia, patching compliance, presence of strabismus, and presence of eccentric fixation were also investigated. Methods: Seventeen amblyopic children were recruited (range of VA in the amblyopic eye, 20/80 to 20/ 400). Visual acuity was assessed at 4, 8, 12, and 16 weeks while participants wore spectacles and/or contact lenses for full refractive correction. Patching treatment was initiated at the 16-week visit. The primary outcome was VA after 16 weeks of refractive correction alone and final VA after 16 weeks of patching. Results: The mean (SD) baseline VA in the amblyopic eye was 0.96 (0.27) logMAR, which improved to a mean (SD) of 0.84 (0.24) logMAR with refractive correction and to a mean (SD) of 0.71 (0.30) logMAR after the addition of patching (PϽ.001). Comparing the final VA with the baseline VA, we found that VA improvement averaged 2.59 lines. The final VA in the amblyopic eye was associated with the baseline VA in the amblyopic eye (PϽ.001), the magnitude of anisometropia (P Ͻ.001), and the level of patching compliance (P =.04). The improvement in VA with patching was inversely associated with participants' age (P=.03) and presence of eccentric fixation (P =.02). Conclusion: Both refractive correction and patching significantly improved the VA of the amblyopic eye associated with myopic anisometropia, with 88% of participants' eyes improving 2 lines or more. Further improvement in VA was observed when patching plus near activities was added to refractive correction and patients were followed for 16 more weeks. We recommend that clinicians treat myopic anisometropic amblyopia with refractive correction and patching plus near activities.

Investigative Ophthalmology & Visual Science, Apr 30, 2015

PURPOSE. To determine whether abnormal macular thickness in myopic anisometropic amblyopia differ... more PURPOSE. To determine whether abnormal macular thickness in myopic anisometropic amblyopia differed after amblyopia treatment. Furthermore, to investigate whether effect of treatment on macular thickness was associated with subject age or improvement in stereoacuity. METHODS. Seventeen children (mean age: 9.0 [63.0] years, ranging from 5.7-13.9 years) with myopic anisometropic amblyopia (visual acuity [VA] in amblyopic eyes: 20/80-20/400) were recruited and treated with 16-week refractive correction, followed by an additional 16-week refractive correction and patching. Macular thickness, best-corrected VA, and stereoacuity were measured both before and after amblyopia treatment. Factorial repeated-measures analysis of variance was performed to determine whether macular thickness in amblyopic eyes changed after amblyopia treatment. RESULTS. Mean baseline VA in the amblyopic eye was 1.0 6 0.3 logMAR and improved to 0.7 6 0.3 after amblyopia treatment (P < 0.0001). The interaction between eye and amblyopia treatment was statistically significant for average foveal thickness (P ¼ 0.040). There was no treatment effect on fellow eyes (P ¼ 0.245); however, the average foveal thickness in the amblyopic eye was significantly reduced after amblyopia treatment (P ¼ 0.049). No statistically significant interactions were found for the other macular thickness parameters (P > 0.05). CONCLUSIONS. Abnormal central macula associated with myopic anisometropic amblyopia tended to be thinner following amblyopia treatment with no significant changes in peripheral macular thickness.

Investigative Ophthalmology & Visual Science, Apr 14, 2011

To compare macular thickness of the normal fellow eye to that of the amblyopic eye using optical ... more To compare macular thickness of the normal fellow eye to that of the amblyopic eye using optical coherence tomography (OCT) in children with unilateral high myopia. Relationships between macular thickness and magnitude of myopic anisometropia, axial length, and visual acuity (VA) were investigated. METHODS. Thirty-one children with a mean age of 9.56 years were recruited. Macular thickness, axial length, best-corrected VA, and refraction were measured. Paired t-test was performed to compare the macular thickness of the amblyopic eye to that of the fellow eye. Partial correlations were used to test the relationships between interocular difference in macular thickness and anisometropia, axial length, and VA. RESULTS. Average (Ϯ SD) LogMAR VA in the amblyopic eye was 0.96 Ϯ 0.31. Mean spherical equivalent in amblyopic eyes was Ϫ10.79 Ϯ 3.40 diopters. A statistically significant difference in macular thickness was found between amblyopic and fellow eyes, with amblyopic eyes having greater foveal thickness but reduced inner and outer macular thickness. Only the nasal outer macular thickness had a statistically significant association with the magnitude of anisometropia. CONCLUSIONS. Amblyopic children with unilateral high myopia tend to have a thicker fovea and thinner inner and outer macula in the amblyopic eye compared to the normal fellow eye. The findings indicate that anatomic changes may be present in the retinas of amblyopic children with unilateral high myopia. Future study is warranted to determine whether the mechanism of the macular changes is due to high myopia, amblyopia, or a combination of the two.

Optometry, Feb 1, 2008

Brain injury caused by an arteriovenous malformation (AVM) hemorrhage is an uncommon occurrence i... more Brain injury caused by an arteriovenous malformation (AVM) hemorrhage is an uncommon occurrence in a teenager. An AVM is a congenital anomaly of unknown etiology, often described as a tangle of arteries and veins that may vary in length and width leading to a loss of capillary bed. The vessels can break down with time and cause hemorrhage or aneurysm. Hemorrhage occurs in a significant number of patients with AVM. Intracranial hemorrhage causes brain injury, which can lead to systemic and ocular complications, neurologic deficits, and death. A 15-year-old girl presented to our clinic with a chief complaint of horizontal diplopia while reading, lasting from seconds to 5 minutes. Nine months before the examination she had a ruptured cerebral AVM, then surgery to control the bleeding. She spent 6 weeks in a coma after surgery and woke up a hemiplegic. There were no visual problems before the bleeding. Our evaluation showed accommodative insufficiency, oculomotor dysfunction, dry eye syndrome, and a right beating latent nystagmus in both eyes. Perceptual testing showed a severe visual sequential memory deficit. The patient was given a reading prescription to aid with accommodation and was to use artificial tears and lacrilube ointment. At the follow-up examination, she reported increased efficiency and fewer episodes of diplopia while reading with bifocals and fewer dry eye symptoms since using the artificial tears. After a brain injury, a young adult can present with perceptual and visual efficiency problems as well as nystagmus. It is important to test all areas that may be affected by this type of event and to investigate all complaints thoroughly with continued follow-up care. A latent nystagmus was discovered during thorough near point testing. The visual perceptual testing helped to confirm the visual sequential memory deficit, which may otherwise have been overlooked. It is believed that the diplopic complaint and poor oculomotor skills were directly related to the newly acquired nystagmus.

Optometry, Dec 1, 2007

Sensory integration dysfunction is a neurologic condition that can cause children to process envi... more Sensory integration dysfunction is a neurologic condition that can cause children to process environmental sensations in an inappropriate way. As a result, they may either seek out strong sensations or avoid even mild sensations. Some of the characteristics of these children may be hyperactivity, poor awareness of pain, high risk taking, listening to loud sounds, clumsiness, poor fine motor skills, poor gross motor skills, poor visual tracking, problems with sequencing, and problems with balance. Sensory integration dysfunction often is related to children with developmental disabilities, autism, and attention deficits. Two children from the same family were examined for general eye examinations because of a history of sensory integration problems. J.H., an 11-year-old girl, and her 6-year-old half-brother, A.T., returned to the clinic for visual-perceptual testing: the Test of Variables of Attention (TOVA), the Developmental Eye Movement Test (DEM), and the Visagraph (Compevo AB, Stockholm, Sweden). The use of yoked prisms with these children was also explored. Both children showed oculomotility problems based on the DEM and Visagraph results. Whereas J.H. performed well on the visual-perceptual profile overall, A.T. showed problems in many areas such as reversals, visual spatial relations, visual sequential memory, visual form constancy, and attention. Both children were low hyperopes and showed positive postural and balance changes when tested with yoked prisms. Children with sensory integration dysfunction can have a number of signs and symptoms that may bring them to the optometrist&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s office. It is important to thoroughly test their visual, perceptual, and oculomotor systems to determine the best way to help these patients. The use of vision therapy and yoked prisms can be beneficial treatment options for many of these patients.

Investigative Ophthalmology & Visual Science, Jun 21, 2021

Investigative Ophthalmology & Visual Science, 2006

Introduction: Vision therapy has been used for years by optometrists to improve the oculomotor sk... more Introduction: Vision therapy has been used for years by optometrists to improve the oculomotor skills in children struggling with reading. Professionals outside of optometry have often criticized the use of vision therapy for these patients. This article reviews the published literature examining the use of orthoptic and oculomotor vision therapy to improve reading skills in patients without specific reading disability. Procedure: Eleven studies published from 1940 to 2001 were evaluated and compared. Summaries, results, and conclusions are presented for each study, as well as a determination of the overall strength of each study. Results: The vast majority of studies shows a weak but positive relationship between oculomotor vision therapy and improved reading skills, such as reading rate and comprehension. The evidence as a whole shows that this improvement is equivalent to that of conventional reading therapy but that the most improvement exists when both vision therapy and readin...

Investigative Opthalmology & Visual Science, 2011

Archives of Ophthalmology, 2012

Investigative ophthalmology & visual science, Jan 18, 2015

To determine whether abnormal macular thickness in myopic anisometropic amblyopia differed after ... more To determine whether abnormal macular thickness in myopic anisometropic amblyopia differed after amblyopia treatment. Furthermore, to investigate whether effect of treatment on macular thickness was associated with subject age or, improvement of in stereoacuity, or improvement of visual acuity (VA) in the amblyopic eyes. Seventeen children [mean age: 9.0 (±3.0) years, ranging from 5.7 to 13.9 years] with myopic anisometropic amblyopia [visual acuity (VA) in amblyopic eyes: 20/80 to 20/400]) were recruited and treated with 16-week refractive correction, followed by an additional 16-week refractive correction and patching. Macular thickness, best-corrected VA, and stereoacuity were measured both before and after amblyopia treatment. Factorial repeated-measures analysis of variance was performed to determine whether macular thickness in amblyopic eyes changed after amblyopia treatment. Mean baseline VA in the amblyopic eye was 1.0 ± 0.3 logMAR and improved to 0.7 ± 0.3 after amblyopia ...

Optometry - Journal of the American Optometric Association, 2007

BACKGROUND: Sensory integration dysfunction is a neurologic condition that can cause children to ... more BACKGROUND: Sensory integration dysfunction is a neurologic condition that can cause children to process environmental sensations in an inappropriate way. As a result, they may either seek out strong sensations or avoid even mild sensations. Some of the characteristics of these children may be hyperactivity, poor awareness of pain, high risk taking, listening to loud sounds, clumsiness, poor fine motor skills, poor gross motor skills, poor visual tracking, problems with sequencing, and problems with balance. Sensory integration dysfunction often is related to children with developmental disabilities, autism, and attention deficits. METHODS: Two children from the same family were examined for general eye examinations because of a history of sensory integration problems. J.H., an 11-year-old girl, and her 6-year-old half-brother, A.T., returned to the clinic for visual-perceptual testing: the Test of Variables of Attention (TOVA), the Developmental Eye Movement Test (DEM), and the Visagraph (Compevo AB, Stockholm, Sweden). The use of yoked prisms with these children was also explored. RESULTS: Both children showed oculomotility problems based on the DEM and Visagraph results. Whereas J.H. performed well on the visual-perceptual profile overall, A.T. showed problems in many areas such as reversals, visual spatial relations, visual sequential memory, visual form constancy, and attention. Both children were low hyperopes and showed positive postural and balance changes when tested with yoked prisms. CONCLUSIONS: Children with sensory integration dysfunction can have a number of signs and symptoms that may bring them to the optometrist's office. It is important to thoroughly test their visual, perceptual, and oculomotor systems to determine the best way to help these patients. The use of vision therapy and yoked prisms can be beneficial treatment options for many of these patients. Optometry 2007;78:644-651

Optometry - Journal of the American Optometric Association, 2008

Background: This study determined if completing an optometry school based home- and in-offi ce vi... more Background: This study determined if completing an optometry school based home- and in-offi ce vision therapy program could decrease symptoms and improve quality of life using the COVD Quality of Life Outcomes Assessment as a measurement tool. Methods: Forty-nine subjects ages 7-45 years with various visual diagnoses completed the 30-item survey before starting vision therapy (Visit 1), again at the six-week visit (Visit 6), and following the completion of the therapy (Final). Data were analyzed by Visit 1, Visit 6, and Final survey summed results. These results were divided into four domains: Physical-Occupational, Social Integration, Somatic Sensation, and Psychological, which are based on the original question categories. Data were also analyzed by age groups to determine if perceptions of changes in quality of life differ between groups. A lower score indicated less severe symptoms. Results: Mean scores were progressively lowered from Visit 1, to Visit 6, to Final Visit for all ...

... audrey.lesperance@uottawa.ca ... 6 Not long after, the Supreme Court of Canada refused to dec... more ... audrey.lesperance@uottawa.ca ... 6 Not long after, the Supreme Court of Canada refused to decide on the claim of Joe Borowski, [1989] 1 RCS 342, that fetuses have a constitutionally guaranteed right to life, saying his case was moot, due to the abortion law being struck down by ...

Optometry - Journal of the American Optometric Association

A complex partial seizure can cause a variety of visual system signs and symptoms, including visu... more A complex partial seizure can cause a variety of visual system signs and symptoms, including visual hallucinations, dilated pupils, and changes in vision. Little information is known about the influence of this disorder on the visual system during nonseizure moments. This case report examines the unusual eye movements-during these nonseizure times-of a patient diagnosed with complex partial seizure disorder. An 8-year-old boy was referred to the clinic by his pediatric neurologist for a comprehensive examination to rule out a visual cause for the abnormal eye movements observed by the patient&amp;amp;amp;amp;amp;#39;s mother. Ocular examination revealed periodic, spontaneous, versional eye movements to the left and right, accompanied by a small widening of the fissures and turning of the head. No vergence or accommodative problems were detected, but Developmental Eye Movement (DEM) and Visagraph testing showed mild dysfunction. Ocular health was unremarkable, while radiology studies and neurological evaluation yielded no observable pathology. Complex partial seizure disorder can affect the visual system in a wide variety of ways. The precise role, if any, that complex partial seizure disorder plays in ocular motility control during nonseizure moments is unknown. The most-plausible etiology of the observed ocular movements in this patient is the presence of a tic disorder. Patients with unknown eye movement disorders deserve a thorough evaluation, including a search for systemic causes.

Varieties of Governance, 2015

Regulation & Governance, 2015